Surgical instrument having an effector

Abstract

The present invention relates to a surgical instrument (1), in particular an HF instrument designed as jaws or a shaft, having an effector (11) or effector region that has two limbs (13) which can be moved relative to one another, of which at least one limb is divided into a distal limb portion (15), intended to be occupied by at least one electrode, and into a proximal limb portion (17), which is electrode free and / or not intended to be occupied by at least one electrode, in the region of which limb portion the two limbs (13) have a coupling point (5) at which they are coupled together for relative movement. The proximal limb portion (17) consists at least in part of a porous, in particular microporous, base material (19) and / or is designed so as to have or is provided with at least partially open, preferably macroporous, cavities, with the exception of the coupling point (5).

Description

[0001] Surgical instrument with an effector

[0002] Description

[0003] Technical area

[0004] The present disclosure relates to a surgical instrument, in particular a medical high-frequency surgical instrument (HF instrument), which is preferably designed in the form of a bipolar vessel sealing instrument, with an effector having two legs movable relative to one another.

[0005] Background of the Revelation

[0006] In high-frequency surgery (also known as HF surgery), a high-frequency alternating current is passed through the human body or a body part to specifically cauterize (coagulate) or cut (electrotomy) tissue through the resulting heat. The damaged tissue is later reabsorbed by the surrounding healthy tissue. A significant advantage over conventional cutting techniques using a scalpel is that bleeding can be stopped simultaneously with the incision by closing the affected vessels, a process known as coagulation.

[0007] Currently, monopolar HF technology is most commonly used in HF surgery. One pole of the HF voltage source is connected to the patient via a counter electrode with the largest possible surface area, for example through contacts on the operating table on which the patient lies, through contact armbands or contact footbands, or through adhesive electrodes. This counter electrode is often called the neutral electrode. The other pole is connected to the surgical instrument and this forms the so-called active electrode. The current flows via the path of least resistance from the active electrode to the neutral electrode. The current density is highest in the immediate vicinity of the active electrode; this is where the thermal effect is most pronounced. The current density decreases with the square of the distance.The neutral electrode should have as large a surface area as possible and be well connected to the body to keep the current density in the body low and avoid burns. The skin at the neutral electrode is not noticeably heated due to its large surface area. Strict safety precautions apply when applying the neutral electrode. To avoid burns, correct positioning and good contact of the neutral electrode (depending on the surgical area) are crucial.

[0008] In bipolar HF technology, in contrast to monopolar technology, the current flows through a small part of the body—the part where the surgical effect (incision or coagulation) is desired. Two mutually insulated metal electrodes, housed in the arms of the HF instrument's effector, with the HF voltage applied between them, are applied directly to the surgical site. The circuit is closed via the intervening tissue. The thermal effect occurs in the tissue between the metal electrodes.

[0009] In such HF instruments, especially bipolar sealing instruments, the effectors are preferably manufactured / designed in a sandwich construction. The effectors consist of or have a thin metal electrode, which acts as the contact surface to the tissue, a plastic spacer, which provides electrical and thermal insulation, and a carrier component, which is designed and configured to ensure force transmission and contains a closing mechanism. The carrier component provides the effector with the necessary stability and rigidity.

[0010] However, such a sandwich-designed effector is complex and costly to manufacture. The various components that must be connected together result in cumulative manufacturing tolerances, which reduces the accuracy of fit and thus the quality of the effector or RF instrument. One approach to addressing these disadvantages is to design / construct the metal electrode or one leg of the effector as a solid component.

[0011] However, such a solid metal electrode has a high thermal mass, which, especially with larger effectors, means that a large part of the energy supplied to the metal electrode by an RF generator does not flow into the tissue sealing but into the heating of the solid metal electrode.

[0012] Another disadvantage of such a solid metal electrode is that the dynamic response of the temperature change is severely limited. This means that the heating and cooling processes take a long time, which increases the duration of the procedure.

[0013] Brief description of the revelation

[0014] The object of the present disclosure is therefore to eliminate or at least reduce the disadvantages of the prior art. Specifically, the object of the present disclosure is to provide a surgical instrument in which temperature control, and in particular the dynamics of a temperature change of the electrode(s) or the electrode carrier(s) / electrode sections of the effector, is improved.

[0015] This object is achieved by a surgical instrument according to independent claim 1. Advantageous further developments are disclosed in the subclaims and / or described below.

[0016] Specifically, the problem is solved by the surgical instrument, in particular an HF instrument (high-frequency instrument) of the forceps or shaft type, with an effector or effector region which has two legs which are movable relative to one another, of which at least one leg is divided into a distal leg section intended for the attachment of at least one electrode (hereinafter referred to simply as electrode for the sake of simplicity) and an electrode-free proximal leg section or section which is not intended for the attachment of at least one electrode (hereinafter referred to simply as jaw part for the sake of simplicity), in the region of which the two legs have a coupling point at which they are coupled to one another in a relatively movable manner.The proximal leg section, i.e., the jaw part of at least one of the legs, consists at least partially of a porous base material (microporous) and / or is formed or provided with at least partially open cavities (macroporous) (at least) outside the coupling point. The term "microporous" refers to cavities that are forming or have formed in the base material, such as those found, for example, in ceramic materials, sponges, foams, sintered materials, and similar materials, or represent a material property. In contrast, the term "macroporous" refers to cavities that are introduced into the possibly already microporous base material in a quasi-constructive (design-based) manner, such as lattice-like structures through a rapid prototype process, through perforation, through drilling, etc., or any other structures, such as those created by churning, stirring, aeration, tempering, etc.It should be noted that microporous and macroporous cavities do not necessarily have to differ in their dimensions, although micropores are usually smaller and / or have a different shape than macropores.

[0017] In other words, the problem is solved by the surgical instrument, in particular an HF instrument (high-frequency instrument), having an effector or effector region with two limbs that are (manually) movable relative to one another between an open state (release or receiving state) and a closed state (clamping or fixing or gripping state) of the surgical instrument, wherein at least one of the limbs has the at least one electrode or the electrode section having a plurality of electrodes for contacting tissue and the jaw part or jaw part section arranged proximal to the at least one electrode or to the electrode section (which is not provided with an electrode or electrodes and is also not intended for contacting tissue). This (electrodeless / electrode-free) jaw part of at least one of the limbs has (or consists of) a porous structure.In other words, the problem is solved by a surgical instrument of either the shaft type (in this case, the legs of the effector are arranged at the distal end of an instrument shaft and coupled to a handle at the proximal end of the shaft via an actuating cable within the shaft) or the scissors or forceps type (in this case, each leg of the effector is preferably integrally connected to a proximally adjoining branch, which in turn forms or has a handle), with a distal, jaw-like effector. The effector has or consists of two legs which can be moved relative to one another via a coupling, for example a joint or a hinge, in a proximal leg section (proximal jaw part), preferably in a scissor-like manner, whereby this proximal leg section (proximal jaw part) of one leg forms a so-called end part.The term end part is a type of (end) box which is a component of one leg and into which the possibly plate-shaped proximal leg section (proximal jaw part) of the other leg is inserted in a relatively movable, preferably relatively pivotable manner.

[0018] The surgical instrument can, for example, be a bipolar HF instrument in a scissors or forceps design or a laparoscope design. The surgical instrument includes at least one, preferably two contact electrodes, each of which is formed on one of the legs, in particular on the distal leg section, or which can be coupled to one of the legs, in particular to one of the distal leg sections. The contact electrodes are preferably at least partially formed from metal or coated with metal. Embodiments with a plurality of contact electrodes are also conceivable, which are arranged distributed over the leg, in particular the distal leg section. The contact electrode preferably includes at least one flat section, which is formed as a contact surface and faces an intermediate space / interior of the effector.Preferably, at least the contact surface of the contact electrode is formed from metal or coated with metal. The jaw part is formed, flanged, or connected to a proximal end portion of the electrode. The jaw part can be coupled, or can be coupled, or connected, or formed with a (proximal) branch. The jaw part has or consists of a porous base material and / or has a porous structure. This means that at least the aforementioned box-shaped, proximal leg portion is porous, at least in some regions.

[0019] Porosity is understood to mean that the jaw part has a hollow portion, at least in some areas, optionally uniformly distributed over the volume or a volume section of the jaw part. In other words, the jaw part can be configured with a plurality of three-dimensionally arranged cavities, which may be interconnected and / or partially open to the outside. The three-dimensionally arranged cavities can preferably be arranged and / or formed in a regular manner, at least in some sections.

[0020] Due to the at least partially porosity of the jaw part in general (according to the above definitions) and in particular due to the at least partially porous base material of the jaw part in concrete terms, the thermally relevant mass of the jaw part can be reduced (significantly), preferably without (or only slightly) compromising the stiffness or strength of the jaw part. Furthermore, a surface area of ​​the jaw part can be (significantly) enlarged (particularly due to the open porosity), so that thermal energy from the jaw part or thermal energy introduced / introduced into the jaw part by the electrode can be dissipated / released into a medium surrounding the jaw part (ambient air, patient fluid, etc.).

[0021] At this point, it should be noted that preferably only the proximal leg section is porous or has porous regions (as defined above) that adjoins the electrode or the distal leg region equipped with electrodes, whereas all other regions, in particular the distal leg section (electrode) and more preferably the branch proximally adjoining the proximal leg section (jaw part), are not (or less) porous. In one aspect, the electrode can have a substantially constant cross-sectional area in a first extension direction from distal to proximal.

[0022] In other words, the electrode can extend substantially in the first extension direction. The first extension direction is a direction extending from a distal end of the jaw-like effector to a proximal end of the effector. The cross-sectional area is a surface that is oriented / spanned substantially normal to the extension direction of the electrode. The cross-sectional area of ​​the electrode can be substantially constant across the extension of the electrode in the first extension direction. In yet other words, the cross-section can be uniform along the electrode, i.e., without large jumps.

[0023] The constant cross-sectional area of ​​the electrode enables uniform heating of the electrode along its length. This can also have a positive effect on the sealing quality of the surgical instrument, generally enabling a more consistent and better seal.

[0024] In a further aspect, the electrode may have at least one elongated hole extending in the first extension direction, wherein a width of the elongated hole changes over the extension of the elongated hole.

[0025] In other words, the electrode can have at least one elongated hole, preferably a plurality of elongated holes. The at least one elongated hole can be formed in a support section facing away from the contact surface of the electrode. The support section can essentially form a T-shape with the contact surface and stiffen the contact surface or the electrode. The width of the elongated hole, i.e. the dimension of the elongated hole in a direction normal to the contact surface, can change from distal to proximal over the extension of the elongated hole along the longitudinal direction of the electrode. Preferably, the width of the elongated hole can increase from distal to proximal.

[0026] In the case where more than one elongated hole is formed in the electrode, the width of each of the elongated holes may increase from distal to proximal across the electrode's length. In other words, the overall width of the elongated holes may increase from distal to proximal across the electrode's length.

[0027] The elongated holes allow for the electrode's contact surface to widen from distal to proximal. In other words, the elongated holes ensure a uniform / constant cross-section of the electrode.

[0028] It should be noted that when considering the cross section, in particular the regions in which the at least one elongated hole is formed are taken into account and intermediate regions which may be formed between two elongated holes adjacent in the longitudinal direction and which make up a considerably smaller proportion of the extension of the electrode may be substantially disregarded.

[0029] In a further aspect, support struts can be formed in the at least one intermediate region.

[0030] In other words, support struts can be formed in the intermediate area between two elongated holes, connecting a rear side facing the support section of the electrode to the support section. The support struts can be solid ribs, inclined columns, or other suitable geometries.

[0031] By forming the support struts, the electrode can be stabilized and the torsional rigidity of the electrode can be increased. The support struts allow the electrode to be further reduced in mass without compromising the strength or rigidity of the electrode. In a further aspect, an insulating cap can be configured to surround the electrode, at least in sections, wherein the insulating cap can be configured with spacer elements to form or delimit at least one, preferably several, air chambers between the insulating cap and the electrode.

[0032] In other words, the insulating cap can be configured to enclose and insulate the electrode, and in particular the support portion of the electrode. The insulating cap can include spacer elements that abut the electrode and position a body of the insulating cap at a distance from the electrode to form the air chamber or chambers between the insulating cap and the electrode.

[0033] Air is a good insulator, so the at least one air chamber formed between the insulating cap and the electrode provides good insulation from the environment surrounding the electrode or effector. This allows for rapid heating of the electrode or the electrode's contact surface and reduces energy loss during the heating process. Furthermore, the insulating cap can reduce the risk of burns for a user of the surgical instrument from the hot electrode.

[0034] In a further aspect, at least one latching hook can be formed on a first, preferably distal, end portion of the insulating cap and a snap edge can be formed on a second, preferably proximal, end portion of the insulating cap in order to engage with the electrode and fix the insulating cap to the electrode.

[0035] In other words, the insulating cap can be designed with a locking and snap-on mechanism to fix the insulating cap to the electrode without the use of tools, preferably in a form-fitting manner. Preferably, the locking hook and / or the snap-on edge of the insulating cap can engage in one or more of the elongated holes in a form-fitting manner. A hook can be designed at the tip, i.e., the distal end, of the electrode to receive the locking hook of the insulating cap.

[0036] The locking and snapping mechanism can permanently connect the insulating cap and the electrode. In an alternative embodiment, the locking and snapping mechanism can be designed to form a detachable connection between the electrode and the insulating cap.

[0037] By designing or connecting the electrode and the insulating cap in this way, the assembly effort of the instrument can be reduced.

[0038] In a further aspect, the porous base material may be or have a lattice structure.

[0039] In other words, the porous base material of the jaw part can be formed as a lattice structure or contain a lattice structure. Alternatively, it is also conceivable to form only sections of the jaw part from the lattice structure.

[0040] In other words, the porous base material can be constructed from three-dimensional, periodically arranged lattice and / or cell structures. Common lattice cells are body-centered cubic cells, face-centered cubic cells, simple cubic cells, or space frameworks. Other possible lattice types / lattice structures are the part graph lattice, the volume graph lattice, the 3D conformal structure lattice, the unit graph lattice, the quad graph lattice, or the ground graph lattice.

[0041] Such grid structures can be manufactured using additive manufacturing processes in different porosities, i.e., with different spacings between the individual grid bars. A grid can absorb forces in different spatial directions and thus contribute to stiffening the jaw or leg without significantly increasing the mass. Depending on the type and size of the leg, the type of grid can be adapted / selected. It is also conceivable to adapt / select the type and design of the grid depending on the location on the metal electrode or a load situation on the jaw.

[0042] The grid structure also makes it easy to increase / enlarge the surface area for heat transfer from the jaw part to the environment without increasing the installation space required for the jaw part.

[0043] In another aspect, the lattice structure may be a three-dimensional crossing lattice structure.

[0044] In other words, the lattice structure can be a three-dimensional lattice structure. The three-dimensional lattice structure can also be an intersecting lattice structure. An intersecting lattice structure is understood to mean a lattice structure in which lattice bars within a lattice standard cell meet or intersect at a center point of the lattice standard cell.

[0045] In other words, the grid standard cell can be designed in such a way that, starting from each corner of the grid standard cell, a grid bar runs towards the center of the grid standard cell and the grid bars cross and / or meet at / in the center of the grid standard cell.

[0046] By designing the lattice structure in this way, the surface area of ​​the lattice structure can be further increased. In addition, the load-bearing capacity and torsional rigidity of the lattice structure can be maximized without significantly increasing the mass of the lattice structure.

[0047] In a further aspect, the porous base material, preferably the porosity or a mesh size or the grid width of the porous base material, can change over an extension of the jaw part, preferably in the first extension direction. In other words, the porous base material can change in a property, in particular in a density of the porous base material or the mesh size or the grid width, in an extension direction of the jaw part.

[0048] In other words, the porous base material itself can differ in its properties from different sections or positions of the jaw part.

[0049] By designing the porous base material in this way, the jaw part can be designed for optimized load and thermal performance. In other words, this design allows for the forces acting on the jaw part to be taken into account while simultaneously reducing material and increasing surface area.

[0050] In a further aspect, the porosity or mesh size of the porous base material may increase in a distal to proximal direction in a stepwise or linear or dynamic manner.

[0051] In other words, the porous base material can decrease in density from the electrode across the jaw. The density decrease can occur in a stepwise or linear manner.

[0052] Such a porous base material design enables effective heat dissipation from the electrode. The further the heat energy is transported / conducted away from the electrode, the coarser the porous base material can be designed to improve heat exchange with the environment.

[0053] In a further aspect, the porosity or mesh size on a force flow path / load section / force conduction section of the jaw part can be reduced.

[0054] In other words, the density of the porous base material of the jaw part can be increased along the force flow path of the jaw part. In still other words, the load section of the jaw part connecting the electrode and the branch can be designed with an increased density, i.e., a reduced mesh size or porosity. Embodiments in which the load section is solid are also conceivable.

[0055] By designing the porous base material in this way, the jaw part can be further optimized in terms of load and thermal performance without significantly increasing the mass of the jaw part.

[0056] In another aspect, the porous base material can be designed as a sponge structure or a bionic structure. A bionic structure is defined as a structure that is based on geometries found in nature or biology.

[0057] In other words, the porous base material can be formed, for example, as a honeycomb structure or as another load-oriented geometry known from nature.

[0058] In other words, the porosity of the porous structure can be designed differently / load-oriented at different locations on the jaw. Furthermore, it is conceivable to change the dimensions of the lattice structure or the rod structures within the lattice structure or to design them differently depending on the load situation / location within the jaw. For example, a load-adapted truss structure can be formed from the rod structures.

[0059] In a further aspect, the electrode and the jaw part can be formed in a heat-conducting manner, preferably in one piece.

[0060] In other words, the electrode and the jaw part can be connected to each other in such a way that heat is dissipated / dissipated from the electrode into the jaw part. Preferably, the electrode and the jaw part can be formed as a single piece, in particular as a single piece of material. In other words, the electrode and the jaw part can be formed monolithically. "Monolithic" means consisting of a single, inseparable unit.

[0061] In other words, the leg can be formed as a single piece. This means that at least the contact surface and the support section, as well as the jaw part, can be formed as a monolithic / single piece with the porous base material.

[0062] The monolithic design allows for high component rigidity. Furthermore, the manufacturing of the leg, and especially the jaw part, is simplified, as a joining process between the individual assemblies and elements is eliminated. Furthermore, the reduction in the number of components prevents the accumulation of manufacturing tolerances, which increases manufacturing accuracy and thus the quality of the HF instrument's effector.

[0063] In a further aspect, at least the electrode and the jaw part can be formed additively, preferably from metal.

[0064] In other words, at least the porous base material can be an additively manufactured structure. Additive manufacturing involves manufacturing processes that are formed by material deposition, preferably in layered buildup processes, and thus differs from abrasive manufacturing processes, in which material is removed.

[0065] In other words, the porous base material can be a 3D-printed structure, which can be formed, for example, by means of selective laser melting, selective electron beam melting, laser cladding, wire arc / plasma arc energy deposition or wire feed electron deposition.

[0066] In a further aspect, the leg can be coated or overmolded with a coating, at least in sections. In other words, the entire mouth can be coated, with the exception of the branch or a branch connection or a branch coupling section and the electrode or the contact surface of the electrode.

[0067] The coating primarily serves as electrical insulation. The coating also has a significant influence on thermal insulation.

[0068] In a further aspect, the coating can be thermally and / or electrically insulating and made of a plastic, preferably polyetheretherketone, polyketone, Rilsan or the like.

[0069] In other words, the coating has good thermal insulating properties.

[0070] In summary, to effectively control heat transfer, heat transfer from the electrode to the insulating cap is minimized. Keeping the contact area between the electrode and the insulating cap as small as possible increases thermal resistance. This can be further enhanced by increasing the thickness of the insulating cap.

[0071] Furthermore, heat transfer from the insulation cap to the environment surrounding the electrode is as optimal as possible. By ensuring the largest possible transfer surface between the insulation and the environment, the thermal resistance is reduced.

[0072] In addition, heat transfer from the electrode to the jaw part is as good as possible. The better the heat transfer from the electrode to the jaw part, i.e., from distal to proximal, the faster the (excess) heat can be dissipated from critical areas of the HF instrument to non-critical areas. This can be achieved by enlarging the heat transfer surface between the electrode and the jaw part. Furthermore, heat transfer from the jaw part to a coating of the jaw part / insulation of the jaw part is as good as possible. The heat temporarily stored in the jaw part should be conducted into the insulation of the jaw part. The thermal resistance can be reduced by ensuring the largest possible contact area between the jaw part and the coating / insulation.

[0073] Furthermore, heat transfer from the (proximal) insulation to the environment is as good as possible. The thin insulation / coating on the jaw is designed to dissipate heat to the environment over the largest possible surface area.

[0074] Finally, it should be noted that the above-mentioned aspects can be claimed individually or in any combination.

[0075] Short description of the characters

[0076] Fig. 1 is a perspective view of a bipolar RF instrument according to the disclosure;

[0077] Fig. 2 is an illustration of a leg of the RF instrument according to the disclosure;

[0078] Fig. 3 is a perspective view of a leg electrode;

[0079] Fig. 4 is an enlarged view of a jaw-like effector of the bipolar RF instrument without a coating;

[0080] Fig. 5 is a schematic representation of a lattice structure of a porous structure of a jaw part of the effector;

[0081] Fig. 6 is an illustration of the jaw part in a first embodiment;

[0082] Fig. 7 is a view of the leg with the jaw part in a second embodiment; Fig. 8 is a view of the jaw part in a third embodiment;

[0083] Fig. 9 is an illustration of the leg with the jaw part in a fourth embodiment;

[0084] Fig. 10 is an illustration of the leg with the jaw part in a fifth embodiment;

[0085] Fig. 11 is an illustration of an insulating cap in a first embodiment;

[0086] Fig. 12 is a view of the insulating cap in the first embodiment mounted on the electrode;

[0087] Fig. 13 is a view of the insulating cap in a second embodiment mounted on the electrode; and

[0088] Fig. 14 is a schematic diagram of a mounting process of the insulating cap on the electrode.

[0089] Description of the embodiments

[0090] Hereinafter, embodiments of the present disclosure will be described based on the accompanying drawings.

[0091] Fig. 1 shows a bipolar HF instrument 1 according to the disclosure. In the embodiment shown here, the HF instrument 1 is designed as a scissor-type instrument. Of course, other designs, such as a laparoscope-type instrument, are also possible.

[0092] The HF instrument 1 includes two scissor elements 3 that are movable relative to one another and are movably connected to one another by a hinge 5 or a terminal part. A branch 7 extends proximally from the hinge 5 in / on each of the scissor elements 3. A ring 9 is formed at a proximal end section of each of the branches 7. The two rings 9 of the two branches 7 can be grasped by a user of the HF instrument 1, and by actuating the rings 9, the scissor elements of the HF instrument 1 can be moved relative to one another.

[0093] A jaw-like effector 11 extends distally from the hinge 5. The effector 11 forms the actual working section of the HF instrument 1.

[0094] Fig. 2 shows a leg 13 of the HF instrument 1. An electrode 15 is formed at a distal end section of the leg 13. The electrode 15 forms a fundamental functional component of the effector 11 of the HF instrument and will be explained in more detail later with reference to Fig. 3. Proximally to the electrode 15, a jaw part 17 is integrally or monolithically connected. The jaw part 17 has or consists of a porous base material 19. A circular receptacle 21 is formed in the porous structure 19 to receive a bolt or a pin or a hinge element of the hinge 5. The jaw part 17 will be explained in more detail later with reference to Figs. 4 to 10.

[0095] Proximally to the jaw part 17 is a branch receptacle 23. The branch receptacle 23 is intended and designed to be fixed to the branch 7. Alternatively, the branch receptacle 23 can be omitted, and the branch 7 can be connected directly to the jaw part 17. In the embodiment shown here, the branch receptacle 23 is formed integrally with the electrode 15 and the jaw part 17. Embodiments are also conceivable in which the branch receptacle is detachably / reversibly connected to the jaw part 17.

[0096] Fig. 3 shows the electrode 15 in a perspective view. The electrode 15 has a flat contact surface 25, which is intended and designed to contact and seal the tissue to be treated. The contact surface 25 faces an interior of the effector 11 with a front side 27. On a rear side of the contact surface 25, a support section 29 extends essentially normally away from the contact surface 25. The contact surface 25 and the support section 29 form a T-beam shape. In other words, a cross-sectional area of ​​the electrode 15 is essentially T-shaped, viewed in the longitudinal direction L of the electrode 15. Along the longitudinal direction L of the electrode 15, i.e., in an extension from distal to proximal, elongated holes 31 are formed in the support section 29. The elongated holes 31 extend in the longitudinal direction L and in a width direction B.The width direction is oriented normal to the contact surface 25 and normal to the longitudinal direction L. The extension of the elongated holes 31 in the width direction, i.e. the width of the elongated holes 31, increases continuously from distal to proximal. At the same time, an extension of the contact surface 25 in a depth direction T increases from distal to proximal. The depth direction T is understood to be a direction which is oriented normal to the width direction B and normal to the longitudinal direction L. The extension of the elongated holes 31 in the width direction B and the extension of the contact surface 25 in the depth direction are coordinated with one another in such a way that the cross-sectional area of ​​the electrode remains essentially constant in a plane spanned by the width direction B and the depth direction T along the longitudinal direction L of the electrode.Embodiments are also conceivable in which the width of the elongated holes 31 changes gradually from distal to proximal, preferably increasing.

[0097] Support struts 33 are formed between the elongated holes 31 to connect the contact surface 25 and the support section 29. The support struts 33 are oriented substantially at a 45° angle to the contact surface 25 and to the support section 29. The support struts 33 are provided and designed to increase the rigidity, and in particular the torsional rigidity, of the electrode 15. Ribs or the like are conceivable as alternatives to the support struts 33. A hook 35 is formed at a distal tip of the electrode 15, which will be described in more detail later with reference to Fig. 14.

[0098] Fig. 4 shows the leg 13 in a partially assembled state of the effector 11. For the sake of clarity, no coating or sheathing is shown. The jaw part 17 engages in a U-shaped manner around a counterpart 37, which belongs to the other scissor element 3. The counterpart 37 contains a second electrode 39 and is connected to a second of the branches 7. The jaw part 17 has two parallel jaw part walls 41 and a jaw part back 43 connecting the jaw part walls 41. Both the jaw part walls 41 and the jaw part back 43 are formed with the porous structure 19. In other words, the jaw part walls 41 and the jaw part back 43 are essentially formed from the porous structure 19.

[0099] Fig. 5 shows the porous base material 19 in one embodiment. The porous base material 19 forms a three-dimensional intersecting lattice. In other words, the porous base material 19 is formed from periodically arranged lattice cells 45. Each lattice cell 45 includes eight lattice bars 47, each of which extends from a corner of the lattice cell 45 to a center point 49 of the lattice cell. In other words, the lattice structure shown in Fig. 5, which forms the porous base material 19, is a body-centered cubic lattice structure.

[0100] The porous base material 19 forms a cooling structure of the jaw part 17 and thus a cooling structure of the effector 11.

[0101] Of course, other lattice geometries / lattice structures are also possible, such as a cubic face-centered lattice structure in which the lattice bars 47 are arranged along edges of the lattice cell 45.

[0102] Fig. 6 shows the jaw part 17 in a first embodiment. In the first embodiment, a grid cell size is a small grid cell size. In other words, the grid structure is a dense / close-meshed grid structure. In still other words, the density of the jaw part 17 in the first embodiment is high and the porosity is low. In the first embodiment, the grid cell size is essentially constant across the extent of the jaw part 17.

[0103] Fig. 7 shows the leg 13 with the jaw part 17 in a second embodiment. In the second embodiment, the grid cell size is a medium grid cell size. In other words, the grid structure in the second embodiment is a medium-density grid structure. In still other words, the porosity of the jaw part 17 in the second embodiment is a medium porosity. In the second embodiment, the grid cell size is essentially constant across the extension of the jaw part 17.

[0104] Fig. 8 shows the jaw part 17 in a third embodiment. In the third embodiment, a grid cell size is a large grid cell size. In other words, the grid structure in the third embodiment is a coarse / large-meshed grid structure. In still other words, the density of the jaw part 17 in the third embodiment is low and the porosity is high. In the third embodiment, the grid cell size is essentially constant across the extent of the jaw part 17.

[0105] The grid cell size allows the thermal conduction properties and heat capacity and heat dissipation properties of the leg 13 to be adjusted.

[0106] Fig. 9 shows the leg 13 with the jaw part 17 in a fourth embodiment. In the fourth embodiment, the lattice structure is a stepped lattice structure. In other words, the lattice structure is denser at a distal end of the jaw part 17 than at a proximal end of the jaw part 17. In the fourth embodiment shown here, the density of the jaw part 17 changes in three stages. Embodiments are also conceivable in which the density of the jaw part 17 decreases linearly, i.e., dynamically, across the longitudinal extent in the longitudinal direction L of the jaw part 17 from distal to proximal.

[0107] Furthermore, embodiments are conceivable in which the density changes in two, four, five or more stages over the longitudinal extent.

[0108] In the fourth embodiment, the jaw part back 43 is solid. Embodiments are also conceivable in which the stepped or linear change in the density of the lattice structure is also formed on the jaw part back 43. Such a design of the jaw part 17 enables rapid heat dissipation from the electrode 15 while simultaneously achieving high heat exchange performance with an environment surrounding the leg 13 with the jaw part 17. Fig. 10 shows the leg 13 with the jaw part 17 in a fifth embodiment. In the fifth embodiment of the jaw part 17, a denser lattice structure is formed along a force flow line 51 in the jaw part 17. In other words, a partial region of the jaw part walls 41, which connects an electrode connection 53 to the receptacle 21 and the branch receptacle 23, is formed with a lattice structure with a higher density than a main part of the jaw part walls 41.By such a design, the stability of the entire effector 11 can be improved, since the area relevant for stability is reinforced by material accumulation and the area not relevant for power conduction is used for heat dissipation through the coarser grid.

[0109] Fig. 11 shows an insulating cap 55. The insulating cap is provided and designed to be fixed to the electrode 15. Wall-shaped spacer elements 57 are formed on a section of the insulating cap 55 facing the electrode 15 in the assembled state. The spacer elements 57 are provided and designed to form air chambers 59 between the insulating cap 55 and the electrode 15. A latching hook 61 is formed on a distal end section of the insulating cap 55. The latching hook 61 is provided and designed to engage positively with the hook 35 of the electrode (see Fig. 14). Snap edges 63 are formed on a proximal end section of the insulating cap 55 to engage with the elongated holes 31.

[0110] Fig. 12 shows the insulating cap 55 from Fig. 11 in an assembled state. An air gap 65 is formed between the insulating cap 55 and the electrode 15. In other words, the insulating cap 55 does not lie completely flush against the electrode 15 in the assembled state.

[0111] Fig. 13 shows an alternative embodiment of the insulating cap 55. In the alternative embodiment, the insulating cap 55 lies flush against the electrode 15 in the assembled state. In other words, in the alternative embodiment of the insulating cap 55, no air gap is formed between the insulating cap 55 and the electrode 15. A process for mounting the insulating cap 55 on the electrode 15 is described below with reference to Fig. 14. In Fig. 14, the insulating cap 55 is shown in a half-section for better illustration.

[0112] In a first step, the locking hook 61 of the insulating cap 55 is hooked into the hook 35 of the electrode 15. For this purpose, the insulating cap 55 is pushed onto the electrode 15 in the longitudinal direction L. In a second step, the snap edges 63 are brought into engagement with the elongated hole 31. For this purpose, the insulating cap 55 is pushed onto the electrode 15 in the width direction B or in a negative width direction. The snap connection thus formed can be released non-destructively in the reverse order of the steps. In an alternative embodiment, the snap connection can also be designed as a non-detachable (not non-destructively removable) connection.

[0113] The electrode 15 and the jaw part 17 can be formed monolithically additively, i.e. the electrode 15 and the jaw part 17 and optionally the branch holder can be manufactured in one piece using a generative manufacturing process.

[0114] List of reference symbols

[0115] I HF instrument

[0116] 3 scissor element

[0117] 5 Hinge

[0118] 7 Industry

[0119] 9 rings

[0120] II Effector

[0121] 13 legs

[0122] 15 electrode / distal leg section

[0123] 17 Jaw / proximal leg section

[0124] 19 porous base material / porous structure / lattice structure

[0125] 21 recording

[0126] 23 Industry survey

[0127] 25 contact surface

[0128] 27 Front

[0129] 29 support section

[0130] 31 slot

[0131] 33 Support strut

[0132] 35 hooks

[0133] 37 counterpart

[0134] 39 Counter electrode

[0135] 41 Jaw wall

[0136] 43 jawbone

[0137] 45 grid cells

[0138] 47 lattice bar

[0139] 49 Center

[0140] 51 Power flow line

[0141] 53 Electrode connection

[0142] 55 Insulating cap

[0143] 57 spacer element

[0144] 59 Air chamber

[0145] 61 Snap hook 63 Snap edge

[0146] L longitudinal direction

[0147] B Width direction

[0148] T Depth direction

Claims

Claims 1. Surgical instrument (1), in particular an HF instrument of the forceps or shaft type, with an effector (11) or effector region which has two legs (13) which can be moved relative to one another, at least one leg of which is divided into a distal leg section (15) intended for the attachment of at least one electrode and a proximal leg section (17) which is electrode-free or not intended for the attachment of at least one electrode, in the region of which the two legs (13) have a coupling point (5) at which they are coupled to one another in a relatively movable manner, characterized in that the proximal leg section (17) consists at least in regions of a, in particular microporous, porous base material (19) and / or is formed or provided with at least partially open, preferably macroporous, cavities outside the coupling point (5).

2. Surgical instrument (1) according to claim 1, characterized in that the distal leg portion (15) has a substantially constant cross-sectional area from distal to proximal in a first direction of extension (L), in particular in a longitudinal direction of extension of the distal leg portion (15).

3. Surgical instrument (1) according to claim 2, characterized in that the distal leg section (15) has at least one elongated hole (31) which extends in the first extension direction (L), wherein a width of the elongated hole (31) changes in a width direction (B) normal to the first extension direction (L) over the extension of the elongated hole (31).

4. Surgical instrument (1) according to claim 3, characterized in that an insulating cap (55) is designed to surround the distal leg section (15), at least in sections, wherein the insulating cap (55) is designed with spacer elements (57) in order to form at least one air chamber (59) between the insulating cap (55) and the distal leg section (15).

5. Surgical instrument (1) according to claim 4, characterized in that at least one latching hook (61) is formed on a first, preferably distal, end section of the insulating cap (55) and a snap edge (63) is formed on a second, preferably proximal, end section of the insulating cap (55) to engage in the distal leg section (15) and to fix the insulating cap (55) to the distal leg section (15).

6. Surgical instrument (1) according to one of claims 1 to 5, characterized in that the porous base material (19) is or has a lattice structure.

7. Surgical instrument (1) according to claim 6, characterized in that the lattice structure is a three-dimensionally crossing lattice structure.

8. Surgical instrument (1) according to one of claims 1 to 7, characterized in that the porous base material (19), preferably a porosity or a mesh size of the porous base material (19), changes over an extension of the proximal leg section (17), preferably in the first extension direction (L).

9. Surgical instrument (1) according to claim 8, characterized in that the porosity or the mesh size of the porous base material (19) increases stepwise or linearly in a direction from distal to proximal.

10. Surgical instrument (1) according to claim 8 or 9, characterized in that the porosity or mesh size on a force flow path (51) of the proximal leg portion (17) is reduced.

11. Surgical instrument (1) according to one of claims 1 to 10, characterized in that the distal leg section (15) and the proximal leg section (17) are formed with one another in a heat-conducting manner, preferably in one piece.

12. Surgical instrument (1) according to one of claims 1 to 10, characterized in that at least the distal leg portion (15) and the proximal leg portion (17) are formed additively, preferably from metal.

13. Surgical instrument (1) according to one of claims 1 to 12, characterized in that the leg (13) is coated or overmolded with a coating, at least in sections.

14. Surgical instrument (1) according to claim 13, characterized in that the coating is thermally and / or electrically insulating and is made of a plastic, preferably polyetheretherketone, polyketone, Rilsan or the like.

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